Healthcare Provider Details

I. General information

NPI: 1134655145
Provider Name (Legal Business Name): JENNIFER K MURRA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 VERALTA DR
CEDAR FALLS IA
50613-6175
US

IV. Provider business mailing address

4222 VERALTA DR
CEDAR FALLS IA
50613-6175
US

V. Phone/Fax

Practice location:
  • Phone: 319-231-8953
  • Fax:
Mailing address:
  • Phone: 319-231-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00808
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: